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SP 16 - Perio Exam 1 > Non-surgical Therapy - Chemical Home Care > Flashcards

Non-surgical Therapy - Chemical Home Care Flashcards

1
Q

What is the most prominent ingredient in toothpaste?

A

Humectants

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2
Q

What is the second most prominent ingredient in toothpaste?

A

Abrasives

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3
Q

What are the different types of abrasives in toothpaste?

A 
Ca-phosphates
Ca-pyrophosphates
Hydrated Silica
Alumina
Ca-carbonate
Na-bicarbonate
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4
Q

What are some different types of humectants in toothpaste?

A

Glycerine
Sorbitol
Xylitol
Propylene glycol

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5
Q

What does abrasion depend on?

A

Particle hardness
Particle size
Particle shape

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6
Q

T/F - Only subgingival plaque control is necessary to reduce gingival inflammation

A

False - Supragingival plaque control is necessary to reduce gingival inflammation

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7
Q

Supragingival plaque can be reduced by what?

A

Appropriate brushing and flossing

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8
Q

Toothpaste

A

A sophisticated drug delivery system that will deploy efficacious medications in an intact manner, and through a medium that can control the therapy’s administraiton

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9
Q

What is the target of toothpaste?

A

To calcified and/or soft tissues

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10
Q

What is the route of toothpaste

A

Directly to the oral cavity via toothbrush for high concentrations

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11
Q

What is significantly and statistically more effective at reducing plaque and gingival inflammation compared to a fluoride dentrifice?

A

Triclosan/copolymer dentrifice

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12
Q

What helps deliver and retain Triclosan?

A

Copolymer - studies have shown that Triclosan has higher retention of HA and epithelial cells when a copolymer is present

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13
Q

What anti-inflammatory effect does Triclosan have on the periodontium?

A

It prevents TNF-a induced production of PGE2

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14
Q

Why is Triclosan preferred over Stannous Fluoride?

A

Both have anti-inflammatory effects, but SnF causes staining, whereas Triclosan does not

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15
Q

What types of toothpaste are best for tartar control?

A

After 8 weeks, studies have shown that all toothpastes control tartar about the same
After 12 weeks, toothpastes with Triclosan and Colgate Tartar Control control tartar better than others (but they do it about the same level)

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16
Q

How does higher concentrations of fluoride alter caries risk?

A

As fluoride concentration increases, the risk for caries decreases

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17
Q

Why don’t we just use an extremely high concentration of fluoride (especially with kids)?

A

If we use too high a concentration, we can get fluorosis
That’s why we use a smaller concentration of fluoride in kids toothpaste; because they’re more likely to swallow it and cause fluorosis

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18
Q

Why might we use an antimicrobial mouth rinse?

A

Teeth only take up 25% of the oral cavity - and biofilms cover the entire mouth, not just teeth

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19
Q

What are the different active ingredients in mouth rinses?

A

Essential oils
Cetylpridinium chloride
Chlorohexidine

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20
Q

What are Anti-plaque and anti-gingivitis supragingival agents?

A

Phenols
Quaternary ammonium compounds
Bisbiguanides
Herbal extracts

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21
Q

What are the active ingredients in Listerine (Essential Oil mouthrinse)

A

Thymol (0.064%)
Eucalyptol (0.092%)
Methyl Salicylate (0.060%)
Menthol (0.042%)

22
Q

What are indications for Essential Oil mouth rinse?

A

To prevent and reduce plaque, gingivitis, and bad breath

23
Q

What is the action of Listerine?

A

An essential oil-containing mouthrinse to inhibit symptoms of gingivitis

24
Q

Listerine Characteristics

A

26.9% alcohol
Phenolic compound
Has the ADA seal of acceptance for healing control plaque and gingivitis
Became the first over the counter mouthwash in 1914

25
Q

How does EO mouth rinse work?

A

EO exhibits broad-spectrum of activity against gram-positive and gram-negative bacteria
EO non-selectively and rapidly disrupts the bacterial cell wall
EO reduces plaque endotoxin levels and pathogenicity for gingivitis

26
Q

How much plaque and gingivitis reduction can occur when EO mouth rinse is used as directed?

A
  1. 3% reduction in plaque

35. 9% reduction in gingivitis

27
Q

What are the major types of Cetylpridinium Chloride mouth rinse?

A

Viadent

Cepacol

28
Q

How does Cetylpridinium Chloride work?

A

Ruptures bacterial cell membrane, leading to rapid leakage of cell contents and cell death
May alter bacterial metabolism, inhibiting cell growth

29
Q

What are the indication of Chlorohexidine?

A

Used to treat gingivitis and bleeding gums

30
Q

What are some negative effects of Chlorohexidine?

A

May cause tooth discoloration or increase calculus formation
Local hypersensitivity and sometimes generalized allergic reactions have been reported
Biter taste and can cause taste interference

31
Q

What is the mechanism of Chlorohexidine?

A
  • CHX ruptures the bacterial cell wall membrane, leading to rapid leakage of cell contents and cell death
  • Binds salivary mucins, reducing pellicle formation, which in turn inhibits plaque bacteria colonization
  • Binds bacteria, inhibiting adsorption onto the teeth
32
Q

How much plaque and gingivitis reduction has been shown when using Chlorohexidine as directed?

A
  1. 9% reduction in plaque

42. 5% reduction in gingivitis

33
Q

What causes Halitosis?

A

Bacteria and bacterial by-products:
H2S
CH3SH
CH3SCH3

Short chain fatty acids
Polyamines
Nitrogen biproducts
Ketone byproducts
Alkalines
Phenyl byproducts
34
Q

What are different ways to treat halitosis?

A

Eliminate etiological factors
Review oral hygiene habits
Recommend dietary changes

35
Q

What is the main ingredient in Herbal Extracts?

A

Chitosan - derived from Chitin

36
Q

Should you recommend Herbal Extracts?

A

No - not enough studies, so we don’t know how they work

37
Q

How are over-the-counter ingredients making theraputic claims evaluated?

A

The FDA regulates them and assignes them to categories (I, II, III) based on level of safety and efficacy via the New Drug Application process (NDA)

38
Q

How has the FDA categorized Essential Oils and CPC

A

Both are Class I

39
Q

In systemically healthy patients, what is seen with long term use of CHX or EO?

A

No microbial overgrowth
No opprotunistic infection
No development of microbial resistance

40
Q

What is the role of alcohol in mouth rinses?

A

The majority of theraputic mouth rinses contain pharmaceutical-grade denatured alcohol (ethanol) to solubilize ingredients
It’s expectorated and not swallowed, so it shouldn’t be a big deal

41
Q

Who should use alcohol-containing mouth rinses?

A

Alcoholics

Children 12 and younger

42
Q

What is the connection between alcohol-containing mouth rinses and risk of oral cancer

A

Evidence doesn’t support a causal relationship
Pharmaceutical-grade alcohol is free of contaminating carcinogens
ADA recommends they be used as advised by dentists and hygienists

43
Q

What effect can Alcohol/EO containing mouth rinses on patients with Xerostomia?

A

Oral irritation is minimal

Some studies had patients come in with mucosal abnormalities after 7 days, but they were back to normal after 14 days

It is safe as long as it is monitored by a dentist

44
Q

What are safety issues regarding Fluoride?

A

Fluorine is a toxic reactive element

Fluoride can accumulate in the body and continuous exposure can cause damaging effect particularly to the nervous system

45
Q

T/F - Consumption of Fluoride is rare

A

False - it is routine through tea, fish, meat, fruits, etc

46
Q

What are other ways we get exposed to Fluoride?

A

Toothpaste (duh)
Dental gels
Non-stick pans
Razor blades

47
Q

What other things contain Triclosan?

A 
A wide variety of household and personal care products such as:
Handsoap
Depdpramts
Textile fibers
Surgical sutures
48
Q

What is required to get the ADA seal of acceptance?

A

Must be supported with rigorous clinical studies and scientific data
Two 6-month studies
An average of 20% of gingivitis reduction
Products awarded with the seal must present a true and accurate portrayal of intended use and efficacy on the label

49
Q

What are the designs for ADA Clinical Trials?

A

Randomized, crossover, or parallel group; well controlled
Active product must be used in normal regimen v placebo
At least 2 studies conducted by independent investigators are required

50
Q

What population is used for ADA Clinical Trials?

A

Must represent typical product users

51
Q

What methods are used for ADA Clinical Trials?

A

At least 6 months long
Scoring and sampling must be performed at baseline
Qualitative microbiologic plaque sampling must be done
Quantitative plaque measurements must be taken
Safety must be demonstrated

SP 16 - Perio Exam 1 (8 decks)

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